<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" class="form-control" name="row[name]" type="text" value="{$row.name}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Website')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-website" class="form-control" name="row[website]" type="text" value="{$row.website}">
        </div>
    </div>
   <!--  <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Provinceid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-provinceId" class="form-control" name="row[provinceId]" type="number" value="{$row.provinceId}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cityid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cityId" class="form-control" name="row[cityId]" type="number" value="{$row.cityId}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level" class="form-control" name="row[level]" type="text" value="{$row.level}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Abbreviation')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-abbreviation" class="form-control" name="row[abbreviation]" type="text" value="{$row.abbreviation}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('City')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class='control-relative'><input id="c-city" class="form-control" data-toggle="city-picker" name="row[city]" type="text" value="{$row.city}"></div>
        </div>
    </div> -->

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Logo')}:</label>
        <!-- <div class="col-xs-12 col-sm-8">
            <input id="c-logo" class="form-control" name="row[logo]" type="text" value="{$row.logo}">
        </div> -->
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-logo" class="form-control" size="50" name="row[logo]" type="text" value="{$row.logo}">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-logo" class="btn btn-danger plupload" data-input-id="c-logo" data-mimetype="logo/gif,logo/jpeg,logo/png,logo/jpg,logo/bmp" data-multiple="false" data-preview-id="p-logo"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-logo" class="btn btn-primary fachoose" data-input-id="c-logo" data-mimetype="logo/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-logo"></ul>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
